IMPACT OF CARDIOVASCULAR DRUG ON ALL-CAUSE MORTALITY IN SECONDARY PREVENTION. A POPULATION STUDY. (June 2018)

• Record Type: Journal Article
• Authors: Redon, J.; Uso, R.; Trillo, J.L.; Fernandez, A.; Morales, F.; Orozco, D.; Gil, V.; Sanchis, J.
• Is Part Of: Journal of hypertension. Volume 36(2018)Supplement 1
• Publication Date: 2018-06
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000539073.54110.39
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: Drug treatment for secondary prevention of cardiovascular disease is an establish strategy recommended by guidelines. However, a wide gap exists between what the guidelines say and the real life in terms of number of drugs. The objective of the SATURNO study was to assess what is the impact on mortality of the gap in subjects after stroke or transitory ischemic attack (TIA), myocardial infarction (MI) or coronary revascularization (REV) based on Electronic Health Records (EHR). Figure. No caption available. Design and method: Subjects and methods: Patients with a diagnosis of stroke, TIA. MI or REV after January 1st, 2012 were selected from the EHR of the Valencia Community which contain all drug prescriptions. In the present study, three groups of therapy usually recommended for secondary prevention or for control of main cardiovascular risk factors were selected: aspirin, SRA blockers (ACEi or ARB) and statins. All cause mortality was obtained from official sources during 1.7+1.5 years. In order to compare the survival time by groups, according the number of class of drugs, we used Cox proportional hazards models. The mortality in each group and the HR were adjusted for group of number of class of drugs (group 0, group1, group 2, group 3), age (continuous), gender (male, female), systolic blood pressure (continuous), LDL-cholesterol (continuous), HDL-cholesterol (continuous), diabetes treatment (yes, no) and diabetes (yes, no) (Model 1). We further adjusted for hypertension treatment (yes, no) and hypertension (yes, no) (Model 2). We further adjusted for dyslipidemia treatment (yes, no) and dyslipidemia (yes, no) (Model 3). Results: A total of 92436 patients (62% men, mean age 72 yr) were included, 55319 with stroke or TIA, MI 28311 and REV 8059. Among them, 4% were not taking drug of the three groups, 20% one, 33% two and 43% three. The HRs are in the table and the survival curves in the figure Conclusions: In conclusion, the gap between guidelines and reality in the use of cardiovascular protecting drugs largely influence all cause mortality.